Individual
KIMBERLY R BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
263 SPRING HOLLOW DR, LAS VEGAS, NV 89148-2502
(702) 807-1718
Mailing address
PO BOX 33838, LAS VEGAS, NV 89133-3838
(702) 807-1718
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
01/06/2012
Last updated
01/06/2012
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